Healthcare Provider Details

I. General information

NPI: 1851238604
Provider Name (Legal Business Name): HERMOSA BEACH CITY SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1645 VALLEY DR
HERMOSA BEACH CA
90254-2921
US

IV. Provider business mailing address

1645 VALLEY DR
HERMOSA BEACH CA
90254-2921
US

V. Phone/Fax

Practice location:
  • Phone: 424-333-9975
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: SUSAN WILDES
Title or Position: SUPERINTENDENT
Credential:
Phone: 424-333-9975